Glycated hemoglobin level is an independent predictor of major adverse cardiac events after nonfatal acute myocardial infarction in nondiabetic patients: A retrospective observational study

Chin Lan Chen, David Hung Tzang Yen, Chin Sheng Lin, Shih Hung Tsai, Sy Jou Chen, Wayne Heuy Herng Sheu, Chin Wang Hsu

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Abstract

The effect of glycemic control on the prognosis of nondiabetic patients after acute myocardial infarction (AMI) remains uncertain. We investigated whether glycated hemoglobin (HbA1c) is associated with adverse outcomes after AMI in nondiabetic patients. In this observational study, we enrolled nondiabetic patients with AMI in the emergency department of 2 medical centers from January 2011 to September 2014. All patients received primary percutaneous coronary intervention and were divided into 4 groups according to the interquartile range of average HbA1c level (Group I, ≤5.6%; Group II, 5.6%-5.8%; Group III, 5.8%-6.0%; and Group IV, >6.0%). Multivariate logistic analysis was performed to estimate the correlation of HbA1c with major adverse cardiac events (MACEs) after AMI. In total, 267 eligible patients were enrolled; 48 patients (18%) developed MACEs within a median follow-up of 178 days. Univariate analysis showed HbA1c > 6.0%, with a higher risk of MACEs in Group IV than in Group I (odds ratio [OR]: 2.733; 95% confidence interval [CI]: 1.123-6.651 vs OR: 1.511; 95% CI: 0.595-3.835). Multivariate analysis revealed an approximately 3.8 times higher risk of MACEs in Group IV than in Group I (OR: 3.769; 95% CI: 1.30-10.86). The HbA1 level is a significant predictor of MACEs after AMI in nondiabetic patients.

Original languageEnglish
Article numbere6743
JournalMedicine (United States)
Volume96
Issue number18
DOIs
Publication statusPublished - May 1 2017

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Glycosylated Hemoglobin A
Observational Studies
Retrospective Studies
Myocardial Infarction
Odds Ratio
Confidence Intervals
Multivariate Analysis
Percutaneous Coronary Intervention
Hospital Emergency Service

Keywords

  • acute myocardial infarction
  • glycated hemoglobin
  • MACEs
  • nondiabetic

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Glycated hemoglobin level is an independent predictor of major adverse cardiac events after nonfatal acute myocardial infarction in nondiabetic patients : A retrospective observational study. / Chen, Chin Lan; Yen, David Hung Tzang; Lin, Chin Sheng; Tsai, Shih Hung; Chen, Sy Jou; Sheu, Wayne Heuy Herng; Hsu, Chin Wang.

In: Medicine (United States), Vol. 96, No. 18, e6743, 01.05.2017.

Research output: Contribution to journalArticle

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abstract = "The effect of glycemic control on the prognosis of nondiabetic patients after acute myocardial infarction (AMI) remains uncertain. We investigated whether glycated hemoglobin (HbA1c) is associated with adverse outcomes after AMI in nondiabetic patients. In this observational study, we enrolled nondiabetic patients with AMI in the emergency department of 2 medical centers from January 2011 to September 2014. All patients received primary percutaneous coronary intervention and were divided into 4 groups according to the interquartile range of average HbA1c level (Group I, ≤5.6{\%}; Group II, 5.6{\%}-5.8{\%}; Group III, 5.8{\%}-6.0{\%}; and Group IV, >6.0{\%}). Multivariate logistic analysis was performed to estimate the correlation of HbA1c with major adverse cardiac events (MACEs) after AMI. In total, 267 eligible patients were enrolled; 48 patients (18{\%}) developed MACEs within a median follow-up of 178 days. Univariate analysis showed HbA1c > 6.0{\%}, with a higher risk of MACEs in Group IV than in Group I (odds ratio [OR]: 2.733; 95{\%} confidence interval [CI]: 1.123-6.651 vs OR: 1.511; 95{\%} CI: 0.595-3.835). Multivariate analysis revealed an approximately 3.8 times higher risk of MACEs in Group IV than in Group I (OR: 3.769; 95{\%} CI: 1.30-10.86). The HbA1 level is a significant predictor of MACEs after AMI in nondiabetic patients.",
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AU - Lin, Chin Sheng

AU - Tsai, Shih Hung

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AU - Hsu, Chin Wang

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